The following key strategies of research towards regeneration/recovery after spinal cord injury are described below (source: Christopher Reeve Foundation website):

Neuroprotection.  This strategy is aimed at reducing the secondary damage to the spinal cord hours, days and weeks after the initial injury by the body's immune responses.  If the natural biological ripple effect could be prevented or contained the size of the lesion of loss of function could be significantly reduced.  

Axon Growth and Remyelination.  Axons are the long, slender projection of a nerve cell (neuron) and are the transmission lines of the nervous system.  Axons are sheathed in myelin which acts as insulation for the transmission.  Spinal cord injuries can result in damage to both axons and myelin.  There are many research lines which are focusing on coaxing the growth of new axons and to remyelinate new and existing axons.

Growth Inhibition.  Due to the body's natural immune responses, the environment around a lesion becomes hostile territory for axonal regeneration.  Researchers now believe that neurons would be able to regenerate new axons if it were not for the body's natural inhibitory responses.  There are many strategies which now are now focusing upon mechanisms which can "inhibit the inhibitors" to allow for a less hostile enviroment for natural regeneration of axons.

Axon Guidance and Synapse Formation.  In order to rebuild nerve circuitry and restore lost function, newborn axons must travel distances up to several feet, recognise their target neurons, and forge working connections — or synapses — with them.  In addition, the full complement of neurotransmitters, the chemicals that improve neuron-to-neuron communication, and their receptors also must be restored.   Many studies are now researching how certain guidance molecules keep elongating axons on track and how the growing tip of the axon receives information and nourishment during the journey. 

Cellular Replacement and Scaffolds.   In some cases spinal cord repair requires the replacement of neurons and support cells which have been damaged or destroyed by the injury and its aftermath.  Researchers are now trying to generate dependable lines of stem cells that, when transplanted, would evolve into the cell types of repair the injured cord.  Other researchers are experimenting with different types of cells which act as scaffolds to support new axons and keep them on track as they grow across the breach.  Both cells and tiny devices can be engineered to deliver substances that would promote the regenerative process as well as protect surviving cells. 

Stem Cell Research. Stem cells hold promise for treating a host of diseases and injuries. The most primitive of these cells, embryonic stem cells, give rise to all the different types of tissues in the body. Researchers are studying how to control the parent cells and the fate of their offspring in order to promote repair in a damaged spinal cord. All types of stem cells are self-renewing in the body and in the laboratory, so large quantities might be grown for medical purposes. Pools of neuroprogenitors also appear to lie dormant in the recesses of the brain and spinal cord that might be roused and dispatched to the site of an injury. Researchers are working on understanding the basic biological mechanisms of stem cells and their role in restoring function to people with spinal cord injury.

For more detailed information about these key lines of research visit http://www.christopherreeve.org

Latest update of this section in January 2011, by Harvey Sihota, member of the Regenerative Research Working Group. For any comments or questions, pls contact president@escif.org